DISORDERS IN FOREGUT DIVERTICULIZATION - CONGENITAL HEPATICOESOPHAGEAL FISTULA IN A BABY WITH LARYNGOTRACHEOESOPHAGEAL CLEFT

Congenital fistulae between the biliary tract and the proximal foregut are rare, Nineteen cases have been reported involving a fistula tract between the left hepatic duct and the distal trachea or proximal bron chus. Herein the authors describe a fistula between the hepatic duct a nd the esophagus, A baby girl had a type III laryngotracheoesophageal cleft repaired in the neonatal period, In the course of investigating her bilious vomiting a DISIDA scan showed radionuclide excretion into the distal esophagus, A percutaneous cholangiogram through the gallbla dder showed no drainage from the common bile duct into the duodenum, w hile the proximal left hepatic duct drained into the distal esophagus, The fistula was divided adjacent to the esophagus and the biliary sys tem was drained through a Roux-en-Y cholecystojejunostomy Fourteen mon ths later she is doing well with no evidence of hepatic compromise, Co pyright (C) 1997 by W,B, Saunders Company.